World Neurosurg
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To decrease vehicular traffic in major metropolitan cities throughout the United States, multiple ridesharing companies have launched dockless electric scooters and bicycles throughout cities. From September 2017 through November 2018, Washington, DC, launched a 15-month dockless vehicle pilot program to allow for the rapid entry and growth of electric scooters within the metropolitan area. This rapid growth resulted in a number of minor and significant injuries. ⋯ In this case series, we highlight more severe injuries that resulted in hospitalization or intervention, including skull fracture, central cord syndrome, and vertebral compression fracture. This case series aims to illustrate the potential severity of injuries related to electric scooters, raise awareness on the issues of safety and public health, and call for further investigation into injuries relating to electric scooters.
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Comparative Study
Efficacy and safety of using high viscosity bone cement vertebroplasty in the treatment of osteoporotic vertebral compression fractures with intravertebral cleft.
To evaluate and compare clinical outcomes and cement leakage of high-viscosity bone cement versus low-viscosity bone cement vertebroplasty in treating osteoporotic vertebral compression fractures with intravertebral cleft. ⋯ Percutaneous vertebroplasty using HVC to treat osteoporotic vertebral compression fractures with intravertebral cleft significantly reduces cement leakage and improves the safety of the operation. In terms of clinical efficacy and prevention of augmented vertebral recollapse, HVC may not have obvious advantages.
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Postoperative seizures are potential complications of chronic subdural hematoma (cSDH). Knowledge of risk factors may help to identify patients that may benefit from antiepileptic prophylaxis. ⋯ Perioperative antiepileptic prophylaxis may be recommended in patients with preoperative midline shift. Membranectomy may not be routinely applied during surgery.
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In this video, we demonstrate a case of a 21-year-old right-handed man who presented with palmar hyperhidrosis. His symptoms started at the age of 4 years and progressively worsened throughout his life. Multiple medical treatments were used without significant benefit. ⋯ A chest radiograph was obtained intraoperatively, and no pneumothorax was observed. At the end of the procedure, both upper extremity temperature probes showed a significant increase from baseline. Informed patient consent was obtained.
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Current guidelines recommend the administration of nimodipine for the prevention of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). However, nimodipine can lead to significant drops in mean arterial pressure and cerebral perfusion pressure. Catecholamines are then used to maintain them while nimodipine is reduced and/or held. There is no evidence that nimodipine retains its neuroprotective effect at lower doses. We aimed to investigate the role of nimodipine interruption in the setting of aSAH and its possible impact on the incidence of DCI. ⋯ Our analysis reveals a greater incidence of DCI in patients with aSAH when nimodipine is interrupted.